How much of a financial toll did COVID-19 take on radiology?

The COVID-19 pandemic led to significant drops in revenue and income for radiology departments, according to an analysis published March 26 in Seminars in Ultrasound, CT, and MRI.

A team led by Ahmed Farag, MD, from the University of Massachusetts Chan Medical School-Baystate Medical Center reported that their institution experienced a considerable loss in imaging volume and a large loss in revenue in 2020, the first year of the pandemic in North America, compared with the previous year.

“Radiology has been one of the hardest hit departments in healthcare, with resounding effects that have outlasted the pandemic itself, some of which have reshaped the field and perhaps permanently,” the Farag team wrote.

The overall medical field experienced unprecedented challenges during the COVID-19 pandemic as facilities hastily reallocated resources toward fighting the onslaught of the disease. Radiology experienced a significant burden of damage, with departments reporting disruptions in day-to-day imaging workflows and operations.

Farag and colleagues wrote that the pandemic highlighted the vulnerability of radiology departments to global health crises. They noted that the pandemic’s impact underscores the need for resilient financial planning and operational flexibility.

The team reported that its institution experienced a maximum drop in revenue of 66% in April 2020 to about $2 million. During the same month in 2019, the reported revenue hovered around $6 million. By June 2020, revenue mostly leveled out, at 5% less than that of the same month in 2019.

Additionally, imaging volume dropped by 61% in April 2020 compared with April 2019 to under 20,000 orders. This mostly recovered by June 2020, though imaging volume was 9% less than that of 2019. The team cited reports from multiple institutions, which indicate losses of outpatient volume with figures in the 50% to 70% range.

“This severe decrease in volume caused an almost universal loss of revenue across all types of radiology practices,” the study authors noted.

The researchers also reported variability in the pandemic’s impact across different subspecialties and medical centers when it comes to the complexity of imaging studies. They highlighted, to their surprise, that their institution did not experience a drop in work relative value units (wRVU) per scan. The researchers reported a slight increase in wRVUs in May and June of 2020.

They wrote that the overall variability “reflects a complex interplay between patient care priorities and healthcare resource allocation, challenges that were not foreseen as part of managing a healthcare crisis of this magnitude.”

As for workflow and personnel, the pandemic forced facilities to have workers perform their duties remotely. However, the team pointed out that costs for home workstations include high-speed internet and meeting hospital-grade technical specifications.

“A residency program that installed 28 workstations for its residents during the pandemic estimated that each machine cost $2,126, not including any additional installation costs and not accounting for the time investment by information technology personnel for setup,” it added.

And while the use of lower contrast doses persists even after shortages experienced during the pandemic, the increase in contrasted studies performed may offset this loss, the researchers wrote.

Finally, the team highlighted that financial strategies implemented during the pandemic focused on limiting spending. These included cessation of hiring temporary radiologists, having employees take paid leave earlier in the fiscal year, and instituting periods of mandatory unpaid leave, among others.

“Key sources of support such as the CARES Act, the Paycheck Protection Program, and some tax relief measures played a crucial role in providing financial relief when no viable alternative was present,” the team wrote.

They concluded that such measures taken during the pandemic provide valuable lessons for similar challenges that may arise in the future.

The full analysis can be found here.

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